Infection Control Progress Report Trust Board Nizam Damani

Infection Control Progress Report Trust Board Nizam Damani

Infection Control Progress Report Trust Board Nizam Damani Clinical Director: Infection Prevention & Control 26th November 2009 1 Priorities for Action Target 2009 BASELINE 2007-08 TARGET 2009-10 No. of cases per month Apr May Jun Jul Aug Sept

Oct 25th Nov MRSA 14 20 (+6) 1.70 1 2 1 3 0 1 1 2 MSSA

46 33 (-13) 2.8 2 4 4 6 3 3 6 3 C difficile 134 99 (-35)

8.25 6 5 3 2 2 5 6 6 Southern Trust C difficile Cumulative Total April 2009 25 Nov.2009 120 100 80 <65 60 >65 Target

40 20 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 3

Southern Trust C difficile Jan 2008 25 Nov 2009 40 35 30 25 20 15 10 5 CAH DHH Lurgan Others Southern Trust Linear (Southern Trust) 0 4 C Diff CDSC Data September 2009 C difficile: Pre and post intervention No of patients Pre intervention period

May 08 - Jan 09 ( 9 months) Post intervention period Feb Oct 09 ( 9 months) Difference 183 40 143 fewer cases Cost saving : 143 x 4000 * = Total saving of 572,000 achieved No. of bed days : 143 x 21* days = Total of 3,003 bed days released *Dept of Health, 2007 Southern Trust MRSA Cumulative Total April 2009 25 Nov 2009 25 20 15 <2 Days >2 Days

Target 10 5 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

7 2008 Belfast 2009 2008 Northern 2009 2008 2009 SouthEastern 2008 Southern 2009 2008 Western 2009 Quarter 3 Quarter 2 Quarter 1 Quarter 4

Quarter 3 Quarter 2 Quarter 1 Quarter 3 Quarter 2 0.30 Quarter 1 0.35 Quarter 4 0.40 Quarter 3 Quarter 2 Quarter 1 Quarter 3 Quarter 2 Quarter 1

Quarter 4 Quarter 3 Quarter 2 Quarter 1 Quarter 3 Quarter 2 Quarter 1 Quarter 4 Quarter 3 Quarter 2 Quarter 1 Quarter 3 Quarter 2 Quarter 1 Quarter 4

Quarter 3 Quarter 2 Quarter 1 MRSA patient episodes per 1,000 episodic occupied bed days MRSA CDSC Data September 2009 Belfast Trust Quarterly Rates Northern Trust Quarterly Rates South Eastern Trust Quarterly Rates Southern Trust Quarterly Rates Western Trust Quarterly Rates 2008 Trust annual MRSA rate 0.25 0.20 0.15 0.10 0.05 0.00 Southern Trust MSSA Cumulative Total

Apr 2009 25 November 2009 35 30 25 20 <2 Days >2 Days 15 Target 10 5 0 Apr May Jun Jul Aug Sep Oct Nov

Dec Jan Feb Mar 9 2008 Belfast 2009 2008 Northern 2009 2008 2009 SouthEastern 2008 Southern 2009 2008 Western 2009

Quarter 3 Quarter 2 Quarter 1 Quarter 4 Quarter 3 Quarter 2 Quarter 1 South Eastern Trust Quarterly Rates Quarter 3 Belfast Trust Quarterly Rates Northern Trust Quarterly Rates Quarter 2 Quarter 1 Quarter 4 Quarter 3 Quarter 2

Quarter 1 Quarter 3 Quarter 2 Quarter 1 Quarter 4 Quarter 3 Quarter 2 0.40 Quarter 1 Quarter 3 Quarter 2 Quarter 1 Quarter 4 Quarter 3 Quarter 2 Quarter 1

Quarter 3 Quarter 2 Quarter 1 Quarter 4 Quarter 3 Quarter 2 Quarter 1 MSSA patient episodes per 1,000 episodic occupied bed days MSSA CDSC Data September 2009 Southern Trust Quarterly Rates Western Trust Quarterly Rates 2008 Trust annual MSSA rate 0.35 0.30 0.25 0.20 0.15

0.10 0.05 0.00 RCA for MRSA and MSSA April Oct 09 : Total no : 37 No of patients RCA carried out Preventable Infections MRSA 9 9 6 MSSA 28 24

11 Total 37 33 (89%) 17 (46%) Age Distribution of RCA Returns (n=33) 14 12 10 8 MSSA MRSA 6 4 2 0 < 1 Month 1 to 5

11 to 20 31 to 40 41 to 50 51 to 60 6 to 10 61 to 70 71 to 80 81 to 90 Preventable Infections No. =17 10 : IV related infections 7 Other Other 41% IV Cannula Other IV Cannula 59% MSSA/MRSA bacteraemia reduction action plan Protocol for insertion of peripheral IV line to reduce unnecessary insertion

Introduction of IV line monitoring form (forms are with the printer) Introduction of competence based training both for medical and nursing staff MSSA/MRSA bacteraemia reduction action plan Introduce standardized IV line pack Pilot sites: One medical and one surgical ward in Craigavon and Daisy Hill Hospital Introduce NEW RCA Forms NEW RCA Forms Antimicrobial Stewardship Antibiotic Stewardship Compliance with antibiotic guidelines in the Southern Trust 100% 90% 90% Feb 09 (n=348) Mar 09 (n=384) 93%

94% 92% Apr 09 (n=303) May 09 (n=335) Jun 09 (n=315) 95% 96% 95% 96% Jul 09 (n=332) Aug 09 (n=269) Sep 09 (n=232)

Oct 09 (n=259) 84% Percentage Compliance 80% 60% 40% 20% 0% Jan 09 (n=556) 22 Expenditure on Antibiotics HOSPITAL SOUTHERN TRUST DIRECTORATE (All) Antibioitic expenditure in the Southern Trust 120000 Sum of COST 100000

80000 RISK GROUP MEDIUM LOW HIGH 60000 40000 20000 2008 2009 YEAR MONTH Estimated annual saving: 300,000 OCTOBER SEPTEMBER AUGUST JULY JUNE MAY

APRIL MARCH FEBRUARY JANUARY DECEMBER NOVEMBER OCTOBER SEPTEMBER AUGUST JULY 0 Antibiotics Consumption HOSPITAL SOUTHERN TRUST Antibiotic Consumption in the Southern Trust 60 Sum of DDD PER 100 OCCUPIED BED DAYS

50 40 RISK GROUP HIGH LOW MEDIUM 30 20 10 0 JANUARY FEBRUARY MARCH APRIL MAY MONTH JUNE JULY

AUGUST Antibiotic Stewardship Feedback to individual consultants on compliance and antibiotic ward rounds Continue antibiotic ward rounds to Medical & Surgical wards Resource issues: medical, microbiologists & pharmacist December 2009: Establish Trust wide Antibiotic Management Team 2010: Revised antibiotic guidelines both for treatment and prophylaxis Zero tolerance to Catheter-related Bloodstream Infections (CR-BSI) 0 Sep-09 Oct-09 Aug-09 Jun-09 Jul-09 M ay-09 Mar-09

Apr-09 40 Jan-09 Feb-09 Dec-08 Oct-08 Nov-08 Sep-08 Jul-08 Aug-08 M ay-08 Jun-08 Apr-08 Feb-08 M ar-08 Dec-07 Jan-08 Nov-07 Sep-07

Oct-07 Aug-07 Jun-07 Jul-07 Apr-07 May-07 M ar-07 Jan-07 Feb-07 Dec-06 Oct-06 Nov-06 No. of infections per 1000 line days Central Venous Catheterassociated Blood Stream Infections Craigavon & Daisy Hill Hospital 140 120 100

80 60 ICU: No CR-BSI since Jan 2009 20 27 Help develop Regional Guidelines on the Insertion and Management of Central line infections in Paediatrics Nizam Damani (chair) and Christine Armstrong 28 Infection Control Workshop Patients and Client Council Thank you

Recently Viewed Presentations

  • L10: Floating Point Issues and Project

    L10: Floating Point Issues and Project

    There are N pixels, with the 3D pixel data represented by x, y, and z (inputs) and Q (output). As you can see, the algorithm is embarrassingly data-parallel. ... (read GPU Acceleration of the Generalized Interpolation Material Point Method Wei-Fan...
  • Biometrics and Statistical Genetics Center at the University

    Biometrics and Statistical Genetics Center at the University

    The Biometrics & Statistical Genetics Center (BSGC) is a scientific group that works on statistical analysis of biological data. Our mission is to implement sound statistical research towards understanding the genetic architecture of complex traits and to advance breeding programs...
  • JET PROPULSION - AIMES, Srinivas Integrated Campus,Mukka

    JET PROPULSION - AIMES, Srinivas Integrated Campus,Mukka

    • In 1903, the Wright Brothers flew, "The Flyer", with a 12 horse power gas powered engine. • From 1903, the year of the Wright Brothers first flight, to the late 1930s the gas powered reciprocating internal-combustion engine with a...
  • Non-Experimental Research

    Non-Experimental Research

    Non-Experimental Research = research in which the experimenter does not have complete control over the conditions of the study Researcher gives up some control in order to get the data
  • 35xs6u1zhs1u1p3cy926rkn4-wpengine.netdna-ssl.com

    35xs6u1zhs1u1p3cy926rkn4-wpengine.netdna-ssl.com

    The Foster Family Satisfaction Survey was developed to assess the foster family's satisfaction in working with the agency (Prohn, 1993; Reid & Gundlach, 1983 ). The Foster Family Satisfaction Survey is a 10 item scale designed to assess foster family's...
  • mrpepperphysics.weebly.com

    mrpepperphysics.weebly.com

    As the object is moved farther away, penumbras are formed and cut down on the umbra. When it is very far away, all the penumbras mix together into a big blur. 27.6. Shadows. A penumbra occurs when the moon passes...
  • Descending Inhibition of Pain - IMMPACT

    Descending Inhibition of Pain - IMMPACT

    Descending Inhibition of Pain. Roland Staud, M.D. Professor of Medicine. University of Florida. An important mechanism by which humans and animals process incoming nociceptive information is top-down modulation, either through inhibition or facilitation of the nociceptive input after tissue damage.
  • Issue Y2K The Great War for Talent! - Excellence Now

    Issue Y2K The Great War for Talent! - Excellence Now

    27. CDE execs know there is a chasm between "excellent design" and "game-changer design." 28. Gasp-worthy design is a moving target! 29. No Broadway shows last forever. So too, great designers! (Hire them! Pay them! Cherish them! Nurture them! Fire...